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Rhinoplasty, or a “nose job”, may be desired for either functional and/or cosmetic purposes and involves reshaping of the nose. It is often combined with a septoplasty, or straightening of the nasal septum, to improve breathing. Rhinoplasty may be used to treat congenital irregularities or to treat damage to the nose sustained by trauma.
There is a range of surgery performed from the simplest bump removal to full reconstruction of the nose. Dr. Davison performs the full spectrum of rhinoplasty operations. His board certification in the specialty of ear, nose and throat (ENT) ensures that considers function, even when making cosmetic changes. Dr. Davison performs both open (incision) and closed rhinoplasty techniques and he tailors them to the patients individual needs with up-to-date techniques. Packing of the nose is rarely necessary and recovery is approximately one week and involves wearing of a surgical splint. Surgery takes approximately 1-2 ½ hours and can be done under sedation or general anesthetic.
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Revision rhinoplasty addresses functional or cosmetic dissatisfaction with results after previous nasal surgery. As a plastic surgeon, facial plastic surgeon and ENT physician, Dr. Davison has considerable experience and skill in performing revision rhinoplasty and employs current techniques to maximize results. Dr. Davison favors using a patients’ own natural tissues versus implants or cadaver tissues. Surgery may require approximately 2 ½ - 3 hours dependent on complexity. Breathing without packing is possible after surgery.
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Septorhinoplasty is a functional “nose job”. It is a combination of septal (partition) straightening with cosmetic changes to the nose. This combination is common and the functional portion may be covered by insurance. Dr. Davison’s emphasis in septorhinoplasty is the functional outcome. Cosmetic changes are natural and are chosen to avoid affecting the previously mentioned functional outcome A septorhinoplasty is commonly performed after a broken nose to repair the fracture damage. The “hump” can be reduced, the nasal tip thinned and the nose narrowed. This operation takes approximately 2 ½ hours. Splints and a cast are worn during the approximate one week recovery.
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A secondary rhinoplasty is necessary to correct dissatisfaction with the appearance of the nose or with breathing problems after a previous rhinoplasty. It is not uncommon for a nose to have been operated on in excess of what is required. This type of nose may require grafts or additional cartilage to improve the physical appearance and the breathing. Dr. Davison uses spreader grafts to open up the breathing (or valve). He uses both open and closed techniques. This operation may require 2-3 hours to perform and approximately one week recovery.
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A facelift is performed to remove extra skin in the face, neck, and jowls. The goal is to eliminate laxity while giving the patient a natural, non-stretched appearance. There are many types of facelifts and Dr. Davison is proficient in them all, from the simplest to the most complex. Again, his expertise in facial/head and neck surgery enables him to perform either a skin only tightening, a lift utilizing the latest European techniques or a deep-plane facelift. The facelift he will recommend is the one that best suits your needs for a natural but genuine difference. Safety is always a consideration in facelift technique while maximizing results and minimizing scars. The facelift is often combined with fat grafting or volume enhancement to maximize your youthful change. Male facelifts focus on the double chin and maintaining hair-bearing skin.
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A cervicoplasty is neck tightening alone. The incisions are limited to the chin area or behind the ear. Liposuction is an important part of tightening the skin in cervicoplasty. This technique is best for patients who are solely concerned with a double chin or excess neck ”waddle”.
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A platysmaplasty is a type of neck procedure performed for complaints of excess neck skin or “turkey waddle”. The procedure involves tightening of the midline neck muscles. By suturing the muscles together or releasing them through an incision under the chin, the appearance of the neck can be improved tremendously. This is often a key component of a full facelift.
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This is a facelift that concentrates on the cheek and jowl excess. The technique focuses on mobilizing the face volume back on to the cheek. The short-scar facelift, or S-lift, has value in that the scar behind the ear is shortened, thus the hair is not disrupted. This short scar or S-lift face lift is ideal for a younger patient with minimal excess neck skin. The short-scar, or S-lift incisions are hidden inside the ear.
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The SMAS facelift is a facelift technique in which the superficial musculoaponeuritic system (SMAS), the deeper layer of the face, is tightened. This SMAS layer is lifted to provide a foundation for the skin to be “redraped” over. New techniques of plication (tightening) and resection of the SMAS add volume to the face, essentially reversing the aging process without a pulled or pinched look. The length of the incision is tailored to the patient and hidden at the hairline.
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A deep plane facelift is a more powerful facelift. It is a performed at a deeper level to reposition the skin and deeper tissue as one layer. It is indicated for two types of patients: Those patients who need a more powerful technique, OR those whose skin has a poor blood supply as in patients with damage due to smoking or previous scars.
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This is a new European technique that combines skin redraping in a vertical, upward manner. This facelift is ideal for patients that need mild to moderate results. It is suitable for middle-aged patients with less neck skin excess and the results are excellent. The benefits of this type of facelift are that the scars are shorter and disrupt the natural hairline less and are designed to be less visible. Dr. Davison has years of experience with this new yet versatile way of rejuvenating the skin. A mid-face lift is incorporated with a MAC lift to rejuvenate the cheek and give the cheek bone volume.
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A revision facelift is performed on a patient who has previously undergone a facelift and wishes to rejuvenate the face and neck again. It is slightly more complex, as there is scar tissue present from the original surgery. Dr. Davison focuses on utilizing the prior scar so as to avoid adding new scars while maintaining a natural appearance.
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A mid-face lift is designed to lift the cheek fat and soft tissue to accentuate the cheek bones, giving the face a more desireable shape. A mid-face lift can be an integral part of a facelift like the MAC lift or it may be done independently. The lifting of the cheek tissue can be achieved with sutures or more permanent devices. It gives support to the lower eyelid and makes the face more oval and less square.
A browlift is a technique to raise droopy or ptotic eyebrows. Eyebrows that have dropped make a patient appear tired or angry. A number of different techniques are possible and Dr. Davison offers them all. They can be combined with facelifts and eyelid (blepharoplasty) or done alone. The goals are similar to lift, suspend and fix the eyebrow and edge of eyelids higher.
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How your eyes look covey how alert or tired one appears. Heavy upper eyelids or lower bags make people look older than they feel. Eyelids can be rejuvenated and tightened separately or together. The surgery can be combined with functional repair of visual field cuts. It can be done under general anesthesia but is ideal for IV sedation as the patient can appear and close their eyelids ensuing a natural look. Eyelid surgery can be combined with facelift or browlift. A ropey or fixing of the upper brow may enhance the result. Surgery takes 1-3 hours and time off is 3-5 days with full recovery in two weeks.
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Liposuction and liposculpture are one of the most common cosmetic surgery procedures. They can range from very focused anatomical area liposuction like submental liposuction to whole body large volume reduction which requires an overnight observation. Safe outpatient procedure liposuction is under 5000 cc, which is close to 12 lbs of suction. To decrease blood loss, increase patient comfort and safely modern tumescent and wet techniques are used at DaVinci. The ideal liposuction patient is the liposculpture patient who is someone happy with their size yet wants to sculpture certain areas of their body like the side of the thighs.
The double chin or heavy heck can be selectively liposuctioned. It can be done solo under local anesthetic or combined with more invasive facial procedures. The fat harvested can even be reinjected in grooves in the face to help lines or used to plump up the lips. Recovery has mild discomfort and bruising but is normally a weekend type time frame.
As the face ages it looses volume. This is seen around the mouth, in the deep nasolabial grooves and in the lips. Although facial fillers can provide up to 12 months of volume enhancement after the most permanent is grafting with fat or tissue. Dr. Davison feels strongly the patient’s own tissue provides the most natural and best tolerated facial augmentation.
A recent revolution in facial rejuvenation has concentrated in the importance of volume in the young face. This has been paralleled by the advancements in fat grafting. Fat grafting is more successful than ever with 50-80% take. It is a transfer of your own tissue to fill out the face. Nasolabial lines, marionette lines, temporal wasting, thin lips, hollow cheeks can all be treated. It can be combined with surgery such as facelift and blepharoplasty to fill in areas and add volume to the midface. Harvest is done from areas that the patient is unhappy with adding the bonus of liposuction to these areas.
Patients who have lost volume in their lips or had thin lips that bother them are excellent candidates for lip augmentation. There are a large number of alternatives. Dr. Davison favors natural products. Facial fillers, such as Restylane or Juvéderm plus can fill the lip for up to 1 year. But the mobile nature of the lips make these absorb quicker. Fat grafts give a natural fill to the lips, fat survival is approximately 50%, so they need to be overfilled but quickly go down. If fat grafts are inadequate a dermal or facial graft of the patients own tissue, especially when available from other surgery makes a graft long term choice. Other permanent fillers, such as gortex or silicone tubes would be suggested as a last resort.
The most sever atrophy in face occurs from HIV lipodystrophy. Mild wasting can be addressed with serial injections of sculptra (polylactic acid). This cause the wasted area to lay down layer of scar tissue to fill the defect more moderate to severe wasting.
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